Overview

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Fellowship in Cardiac Surgery

The Adult Cardiac Surgery Fellowship at the Massachusetts General Hospital Corrigan Minehan Heart Center is a one or two-year fellowship with one or two positions available per year. It is not accredited by the Accreditation Council for Graduate Medical Education (ACGME).

The cardiac fellow will become experienced in the oversight of a complex service. The fellow's primary responsibility will include the evaluation of emergency cases at night, both in the emergency room and in the catheterization lab. The fellow will:

Curriculum

Lectures and Conferences

The fellow will be an active participant in conferences and in the teaching activities for the cardiothoracic residents and general surgery residents. These include weekly case conferences and didactic lectures, monthly morbidity conferences and periodic invited speakers.

The fellow has the opportunity to attend one national meeting per year funded by the center.

Teaching Staff

One of the established tenets of the program is to separate cardiac and thoracic surgery into distinct teaching units. There are separate nursing units, intensive care units, operating rooms, faculty and conferences for each service. This allows the fellow to devote his or her effort entirely to the area of cardiac surgery, taught by individuals completely dedicated to the field.

The fellow will be supervised by the program director and the cardiac surgery faculty in accordance with the institution’s supervision policy, as well as the supervisory policy approved by the Surgical Coordinating Committee.

Evaluation and Feedback

Written evaluations will be done twice a year by the program director with the input of the faculty. The program director will also meet with the fellow at least twice a year to provide formal feedback, career counseling and obtain input from the trainee.

Clinical Experience

Fellows work closely with faculty such as George Tolis, Jr., MD (above), to develop advanced skills in cardiac surgery.

Building Expertise in Leading Cardiac Care

The cardiac fellow will assist the chief resident in the management of patients on the Cardiac Surgery Service. This involves the care of approximately 1,500 patients per year. The fellow will become experienced in the oversight of a complex service with primary responsibility for the evaluation of emergency cases at night, both in the emergency room and in the catheterization lab. Experiences in the operating room include:

Opening and closing the chest

Cannulating for cardiopulmonary bypass

Mobilizing the mammary artery

Performing valve and coronary operations

The fellow will become acquainted with the preoperative evaluation of emergent and elective patients and also gain expertise in the postoperative care and resuscitation of critically ill patients. The fellow should develop an in-depth knowledge of hemodynamic management and problem solving ability in critical care. The fellow will become efficient in interpreting echocardiogram (ECHO), computed tomography (CT) and catheterization studies, and knowledgeable in the principles of management of coronary disease, valvular heart disease and diseases of the aorta.

The cardiac fellow may, at times, be responsible for the entire service when the chief resident is not available. This would entail organizing the schedule for the staff surgeons and arranging adequate coverage for all the procedures in the operating room. It also involves arranging patients consults when necessary.

Basic science instruction is primarily derived from lectures and rounds, as well as in the course of the cardiac surgery fellow’s clinical duties. Pathologic material is routinely reviewed at cardiac and thoracic surgical morbidity and mortality rounds. Numerous special conferences are also designed primarily for the instruction of cardiac and thoracic surgical residents and fellows. In addition, conferences in cardiology, pulmonary medicine and anesthesia are also open to the cardiac surgery fellow.

The cardiac surgical fellow is expected to take in-house calls in rotation with the first year cardiothoracic residents. He or she will be expected to comply with work hour regulations.